Table 1. Characteristics of patients <5 years of age with suspected pneumonia, septicemia, or meningitis with or without Staphylococcus aureus bacteremia identified through 2 surveillance systems, The Gambia, 2008–2015*.
| Patient characteristic | Patients with S. aureus bacteremia, n = 198 | Patients with bacteremia caused by other pathogen, n = 932 | Patients without bacteremia, n = 24,182 |
|---|---|---|---|
| Age, mo | |||
| <1 | 84/198 (42.4) | 97/932 (10.4) | 1,911/24,177 (7.9) |
| 1–11 | 61/198 (30.8) | 310/932 (33.3) | 8,675/24,177 (35.9) |
| 12–23 | 33/198 (16.7) | 265/932 (28.4) | 7,505/24,177 (31.0) |
| 24–59 |
20/198 (10.1) |
260/932 (27.9) |
6,086/24,177 (25.2) |
| Sex | |||
| M | 97/198 (49.0) | 532/932 (57.1) | 13,740/24,177 (56.8) |
| F |
101/198 (51.0) |
400/932 (42.9) |
10,437/24,177 (43.2) |
| Severely stunted† | 20/109 (18.3) | 216/884 (24.4) | 3,425/21,736 (15.8) |
| Mid-upper arm circumference <11 cm |
81/198 (40.9) |
184/932 (19.7) |
3,080/24,182 (12.7) |
| Admitted in previous 2 weeks | 31/162 (19.1) | 157/843 (18.6) | 3,995/21,897 (18.2) |
| Hospital stay, d, median (IQR) | 5 (2–6) | 4 (3–6) | 3 (2–4) |
| Disease onset during wet season‡ | 97/198 (49.0) | 335/932 (35.9) | 10,335/24,171 (42.8) |
| Died |
28/198 (14.1) |
161/932 (17.3) |
860/24,182 (3.6) |
| Symptoms | |||
| Cough | 103/198 (52.0) | 675/928 (72.7) | 19,523/24,148 (80.8) |
| Difficult breathing | 89/197 (45.2) | 535/927 (57.7) | 14,280/24,102 (59.2) |
| Prostration | 29/197 (14.7) | 147/918 (16.0) | 1,602/23,906 (6.7) |
| Diarrhea | 38/190 (20.0) | 271/861 (31.5) | 5,798/22,772 (25.5) |
| Convulsion |
8/198 (4.0) |
72/927 (7.8) |
1,174/24,127 (4.9) |
| Signs | |||
| Lower chest wall in-drawing | 164/198 (82.8) | 732/927 (79.0) | 17,856/24,129 (74.0) |
| Meningism | 1/192 (0.5) | 34/867 (3.9) | 174/22,841 (0.8) |
| Altered level of consciousness |
124/193 (64.2) |
407/873 (46.6) |
9,590/23,518 (40.8) |
| Axillary temperature | |||
| <36.5°C | 18/198 (9.1) | 79/932 (8.5) | 2,405/24,182 (9.9) |
| 36.5°C–37.5°C | 40/198 (20.2) | 147/932 (15.8) | 6,819/24,182 (28.2) |
| >37.5°C |
140/198 (70.7) |
706/932 (75.7) |
14,958/24,182 (61.9) |
| Pulse rate, beats/min§ | |||
| Increased for age |
84/198 (42.4) |
621/932 (66.6) |
15,107/24,182 (62.5) |
| Respiratory rate, breaths/min¶ | |||
| Increased for age |
128/198 (64.6) |
682/932 (73.2) |
17,157/24,177 (71.0) |
| Oxygen saturation <92% |
33/198 (16.7) |
116/932 (12.4) |
2,140/24,182 (8.8) |
| Suspected diagnosis# | |||
| Septicemia | 109/194 (56.2) | 434/896 (48.4) | 8,549/23,068 (37.1) |
| Pneumonia | 55/194 (28.4) | 347/896 (38.8) | 13,244/23,068 (57.4) |
| Meningitis | 13/194 (6.7) | 96/896 (10.7) | 718/23,068 (3.1) |
| Other focal sepsis |
17/194 (8.8) |
19/896 (2.1) |
557/23,068 (2.4) |
| Malaria positivity** | 14/131 (10.7) | 84/723 (11.6) | 3,276/21,626 (15.1) |
*Values are no. patients/total no. in category (%) except as indicated. Surveillance data are from the Basse Health and Demographic Surveillance System and the Fuladu West Health and Demographic Surveillance System. IQR, interquartile range. †Defined as weight-for-height z-score <3 SDs from median weight-for-height for the corresponding age group. We calculated weight-for-height using z-scores from the 2006 World Health Organization child growth standards in Stata 14.0 (https://www.stata.com/stata14). Neonates were not included in weight-for-height measurements. ‡The wet season occurs during July–November and the dry season during December–June. §The reference ranges for pulse rates were 70–190 beats/min for children <1 month of age, 80–160 beats/min for children 1–11 months of age, 80–130 beats/min for children 1–2 years of age, 80–120 beats/min for children 3–4 years of age, 75–115 beats/min for children 5–6 years of age, 70–110 beats/min for children 7–9 years of age, and 60–100 beats/min for children >10 years of age. ¶Increased respiratory rate was defined as >60 breaths/min for children <2 months of age, >50 breaths/min for children 2–12 months of age, >40 breaths/ min for children >1–5 years of age. #Surveillance diagnosis was categorized into mutually exclusive groups in order of severity; meningitis was considered more severe than septicemia, which was considered more severe than pneumonia. **Malaria was tested using a rapid diagnostic test (ICT Malaria P.f. Antigen, ICT Diagnostics, http://www.ictdiagnostics.co.za).